Strengths and failings of U.S. health care 'system' are driven by embedded vested interests

03/21/05

WASHINGTON, DC--Medical sociologists examine how American social, cultural, and political-economic contexts govern the structure, efficiency, and operational nature of U.S. health care delivery in a special issue of the Journal of Health and Social Behavior (JHSB), a scholarly publication of the American Sociological Association (ASA). With unique strengths in studying organizations, institutions, and the political economy, sociological researchers offer useful insights for researchers of well-being and for health care policymakers through objective and comprehensive overview as well as focused research articles. Made possible by sponsorship from the Robert Wood Johnson Foundation, this special issue of JHSB--titled "Health and Health Care in the United States: Origins and Dynamics"--examines the efficacy of U.S. health care in the world context.

While the United States is one of the richest and most politically powerful nations in the world, its health care system exhibits numerous sociological, political, and economic dilemmas. Embedded in private market competition, the U.S. health care system has become one of the most inequitable, inefficient, and costly systems among those of western industrialized nations. At the same time, the United States delivers some of the finest health care in the world, and yet with more than 16 percent of Americans uninsured, mostly children, many do not have access to or cannot afford this health care.

The JHSB articles shed historical and contemporary light on some of the reasons behind this inequality and explore the function of the health care system by examining the "origins of corporate health care," "the dynamics of health care markets," and "systemic implications of corporatized health care." The journal features analyses over several decades of the development of current institutional arrangements of health care delivery and health care organizations, details about their weaknesses, and the requirements for improving services to acceptable standards.

Among other timely topics, the articles explore the history of U.S. universal health care policy proposals, problems in long-term care, comparisons between managed care chains versus hospital chains, and clinical practice guidelines after a public backlash against managed care. The researchers detail the ways in which organizational, cultural, and professional forces shape the health and medical markets, even as corporate interests transform health care and the health professions.